<html>

<head>
<meta http-equiv="Content-Language" content="en-us">
<meta http-equiv="Content-Type" content="text/html; charset=windows-1252">
<meta name="GENERATOR" content="Microsoft FrontPage 4.0">
<meta name="ProgId" content="FrontPage.Editor.Document">
<title>Personal categories</title>
<base target="_self">
</head>

<body bgcolor="#336699">

<form method="POST" action="--WEBBOT-SELF--">
  <!--webbot bot="SaveResults"
  U-File="C:\source\log database\html\_private\form_results.txt"
  S-Format="TEXT/CSV" S-Label-Fields="TRUE" -->
  <table border="0" width="578" bgcolor="#FFFFFF">
    <tr>
      <td width="568" colspan="2" bgcolor="#DAD3C5"><font face="Arial">Register
        user details</font></td>
    </tr>
    <tr>
      <td width="305" bgcolor="#EEEBE3"><font face="Arial">Full name</font></td>
      <td width="107" bgcolor="#EEEBE3"><input type="text" name="T1" size="26"></td>
    </tr>
    <tr>
      <td width="305" bgcolor="#EEEBE3"><font face="Arial">User name*</font></td>
      <td width="107" bgcolor="#EEEBE3"><input type="text" name="T2" size="26"></td>
    </tr>
    <tr>
      <td width="305" bgcolor="#EEEBE3"><font face="Arial">Password*</font></td>
      <td width="107" bgcolor="#EEEBE3"><font face="Arial"><input type="text" name="T3" size="26"></font></td>
    </tr>
    <tr>
      <td width="305" bgcolor="#EEEBE3"><font face="Arial">Confirm password*</font></td>
      <td width="107" bgcolor="#EEEBE3"><font face="Arial"><input type="text" name="T4" size="26"></font></td>
    </tr>
    <tr>
      <td width="305" bgcolor="#EEEBE3"><font face="Arial">Code*</font></td>
      <td width="107" bgcolor="#EEEBE3"><font face="Arial"><input type="text" name="T5" size="26"></font></td>
    </tr>
    <tr>
      <td width="305" bgcolor="#EEEBE3"><font face="Arial">Profession</font></td>
      <td width="107" bgcolor="#EEEBE3"><font face="Arial"><select size="1" name="D2">
        </select></font></td>
    </tr>
    <tr>
      <td width="305" bgcolor="#EEEBE3"><font face="Arial">Location</font></td>
      <td width="107" bgcolor="#EEEBE3"><font face="Arial"><select size="1" name="D1">
        </select></font></td>
    </tr>
    <tr>
      <td width="305" bgcolor="#EEEBE3"><input type="submit" value="Submit" name="B1"><input type="reset" value="Reset" name="B2"></td>
      <td width="107" bgcolor="#EEEBE3">&nbsp;</td>
    </tr>
  </table>
</form>

</body>

</html>
